Cataract surgery using phacoemulsification doubles the rate of progression of diabetic retinopathy in older patients, according to an Australian study published in the August issue of Ophthalmology.

Researchers at the Universities of Sydney and Melbourne followed 169 diabetic patients with a mean age of 74. After 12 months, 28% of the eyes that underwent phacoemulsification had developed diabetic retinopathy, compared to nearly 14% of the eyes that didn???t receive surgery. Among patients who had surgery in a single eye, nearly 36% had retinopathy, compared to 20% of the eyes that did not undergo surgery, according to the study.

Phacoemulsification may "exacerbate the development and progression of [diabetic retinopathy] in older patients with diabetes, compared with fellow eyes of the same patients that had not undergone phacoemulsification," write the authors.

However, the risk of retinopathy after phacoemulsification is lower than the progression rates associated with older surgical techniques such as intracapsular and extracapsular cataract extraction.

"Although these findings should not argue against performing cataract surgery in older people with diabetes, it is important for clinicians to recognize this residual risk and to take appropriate precautions," write the authors.

—Kent Steinriede